Clonidine en prémédication et anesthésie à l'isoflurane pour la réduction du saignement en chirurgie otologique

Welfringer, P.; Manel, Joan; Garric, J.

doi:10.1016/s0750-7658(05)80001-2

Cited by 14 publications

(6 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the open, controlled, randomized study of Woodcock et al (3), single dose oral premedication with clonidine 0.6 mg in patients undergoing middle ear or nasal surgery significantly reduced the vapor requirement for isoflurane‐induced hypotension, although it did not entirely obviate the need for further supplementary agents to facilitate induced hypotension. In the prospective study of Welfringer et al (12), patients scheduled for ear surgery were randomly assigned to premedication with hydroxyzine alone or combined with clonidine. Anesthesia was maintained with isoflurane and surgical bleeding was assessed on a numerical scale with four values.…”

Section: Discussionmentioning

confidence: 99%

“…Intraoperative bleeding was assessed on a four‐point scale from 0=no bleeding (excellent surgical conditions), 1=minimum bleeding (sporadic suction), 2=diffuse bleeding (repeated suction), and 3=abundant (troublesome) bleeding (continuous suction) (12), by the surgeon (always the same) who performed all surgeries. This scale was selected because it is practical: bleeding scores of 0 and 1 are considered a good surgical field, while scores of 2 and 3 are considered a difficult field for surgery.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Clonidine decreases intraoperative bleeding in middle ear microsurgery

Marchal

Gómez-Luque

Crespo

et al. 2001

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Clonidine decreases intraoperative bleeding in middle ear microsurgery

Marchal

Gómez-Luque

Crespo

et al. 2001

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…There are some recommendations for medications and anesthetics to lower blood pressure and reduce hemorrhage [ 6 - 8 ]. Numerous vasoconstrictor drugs, such as phenylephrine hydrogen chloride (HCl) (0.25%), sodium nitroprusside, esmolol, oxymetazoline HCl (0.05%), cocaine (4%) [ 9 ], and isoflurane (1% by inhalation) [ 10 ] have been investigated as the drugs for controlling hypotension [ 1 ]. The requirement and technique of controlled hypotension were thought to provide a bloodless surgical field and reduce blood loss, particularly during FESS or any other surgical procedure where the surgeon's ability to have a vision of the surgical area can be adversely affected by even a small amount of bleeding.…”

Section: Discussionmentioning

confidence: 99%

A Study of the Effect of Pre-emptive Oral Clonidine on Intraoperative Haemodynamics and Surgical Field Quality During Functional Endoscopic Sinus Surgery Under General Anaesthesia

Khandelwal¹,

Sen²

2023

Cureus

View full text Add to dashboard Cite

IntroductionFor endoscopic sinus surgery for rhinosinusitis, pre-emptive Alpha 2 agonist clonidine has been used to reduce sympathetic output, which lowers blood pressure and consequently surgical bleeding. The aim of this study was to analyze the effects of oral clonidine premedication in patients undergoing functional endoscopic sinus surgery. MethodsThis study was performed between December 2020 to November 2022 among two groups of 30 patients each: clonidine (200 μgm oral) and placebo. Parameters were recorded at baseline, 60 mins after administering the drugs, at induction, and at minutes five, 10, 20, 30, 45, 60, 75, 105, and 120. Six-point average category scale for bleeding was studied. IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, New York, United States) was used for statistical analysis, and p < 0.05 was considered significant. ResultsDemographic criteria were statistically non-significant. Heart rate (HR) and mean arterial pressure (MAP) were statistically non-significant at baseline and the 120th min mark, and were significant at other time intervals. The blood loss grading was less in the clonidine group, and the difference was found to be statistically significant (P < 0.001). ConclusionPre-emptive oral clonidine 200 mcg 60 min prior to induction was found to reduce surgical bleeding by controlling haemodynamics.

show abstract

“…In our study, significant fall in mean HR, SBP, DBP, and MBP was observed in patients receiving clonidine 4 and 5 µg/kg as compared to 3 µg/kg. These findings were similar to the findings of Lee et al .,[ 1 ] Welfringer et al .,[ 7 ] Nishina et al .,[ 8 ] and Kerdawy et al . [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 ] and Welfringer et al . [ 7 ] It may be due to hemodynamic attenuation with clonidine, as diminished sympathetic outflow results from central α 2 adrenoceptor stimulation thus reducing bleeding.…”

Section: Discussionmentioning

confidence: 99%

Effect of intravenous clonidine premedication for the bloodless surgical field in patients undergoing middle ear or nasal surgery: A comparison of three different doses

et al. 2015

View full text Add to dashboard Cite

Aim:To evaluate the effect of intravenous (IV) clonidine premedication for the bloodless surgical field in patients undergoing middle ear or nasal surgery comparing three different doses.Subjects and Methods:This prospective randomized, clinical trial was performed on 90 normotensive patients belonging to American Society of Anesthesiologists grade I/II, aged 18–60 years, of either sex, undergoing routine middle ear or nasal surgery. These patients were divided into three Groups A, B, and C with 30 patients in each according to the dose of IV clonidine used as premedicant that is 3, 4, and 5 µg/kg, respectively. The hypotensive period commenced 10 min after the start of surgery till the surgeon's request for no hypotension required any longer. The target mean blood pressure for producing bloodless surgical field was 60–70 mmHg. During the hypotensive period, the surgeons were asked to rate the bleeding severity score on a six-point scale from 0 (no bleeding) to 5 (severe bleeding).Statistical Analysis Used:ANOVA, Chi-square test, Z-test, standard deviation and P value.Results:IV clonidine premedication in a dose of 4 and 5 µg/kg reduces bleeding and provides a clear field for surgery. It also reduces the requirement of isoflurane, fentanyl, and metoprolol for controlled hypotension. However, clonidine 5 µg/kg was not more effective than clonidine 4 µg/kg in producing these effects rather was associated with some side effects.Conclusion:IV clonidine premedication in a dose of 4 µg/kg is safe and effective for producing a bloodless surgical field in the middle ear and nasal surgery.

show abstract

Clonidine en prémédication et anesthésie à l'isoflurane pour la réduction du saignement en chirurgie otologique

Cited by 14 publications

References 14 publications

Clonidine decreases intraoperative bleeding in middle ear microsurgery

Clonidine decreases intraoperative bleeding in middle ear microsurgery

A Study of the Effect of Pre-emptive Oral Clonidine on Intraoperative Haemodynamics and Surgical Field Quality During Functional Endoscopic Sinus Surgery Under General Anaesthesia

Effect of intravenous clonidine premedication for the bloodless surgical field in patients undergoing middle ear or nasal surgery: A comparison of three different doses

Contact Info

Product

Resources

About